July 2010

Out on a limb: Personality test

Athletes are known for being difficult patients, with psychology often playing as important a role as biomechanics. The objective is to keep an athlete’s personality from getting in the way of proper medical care. But sometimes that’s easier said than done. Just ask the Boston Red Sox.

The Sox are no strangers to injuries this season, coming out of the All Star break with no fewer than a dozen players sidelined. By all accounts, player personalities have been an issue during rehabilitation. But not always in the ways one might think.

Exhibit A is Dustin Pedroia, who suffered a non-displaced navicular fracture on June 26 after fouling a ball off his left foot. The entire Sox medical staff must have cringed at the prospect of trying to explain the concept of non-weightbearing to this guy. The second baseman, after years of hearing that he was too small to succeed, has made an MVP career out of proving people wrong, and his approach to rehab has been no exception.

Less than a week after his injury, Pedroia was back at practice, fielding grounders from his knees with a boot on his injured foot. Two weeks later, he took batting practice while kneeling on a stool. And all along, he insisted there was no way he would be out for the recommended six weeks. As this issue of LER went to press, he was telling reporters he would be back on the field before the Sox finished their next road trip on July 28 – just four and a half weeks since the injury.

Managers love that kind of attitude. Practitioners, not so much. Pedroia is clearly the type of athlete who needs team medical staff to protect him from his own bravado and enthusiasm.

Then there’s Jacoby Ellsbury. At the All-Star break, the outfielder was in his 14th week of rehabilitation for a rib injury, the mysterious details of which have been much debated in the local press. Quotes from teammates and manager Terry Francona have suggested that Ellsbury has always been essentially Pedroia’s opposite in terms of willingness to play hurt.

Unfortunately, it seems that Ellsbury’s reputation for being “soft” may have affected his medical care. The player told reporters that after his initial attempt to return to play in April, his request for an MRI was refused until his agent stepped in to advocate on his behalf. The MRI revealed that what had previously been diagnosed as a bruise was actually several fractured ribs.

If this is true, it’s baffling. The Red Sox are one of the richest teams in baseball. Why wouldn’t they want the most accurate diagnosis, as expediently as possible? Letting a player’s personality affect that decision, if that’s what happened, is neither good business nor good medicine.

Most sports medicine practitioners don’t treat professional athletes, but weekend warriors and competitive amateurs have personalities too. Some will drive you crazy with their need to push the envelope, others with their need to play it safe. But they all deserve quality care.

One Response to Out on a limb: Personality test

Excellent note, yet there is the other side to the story, the one where sidelining an athlete is frown upon. “Soft” players, are usually staff designated. “Macho” is encouraged and get better attention. With flaws on both sides, as usual.